O'Reilly on Health Care Reform
Reported by Marie Therese - September 14, 2004 -
The O'Reilly Factor. September 8, 2004. 8:37 PM to 8:43 PM EDT.
Guests: Dr. Steffie Woolhandler, Harvard Medical School, co-founder of Physicians for a National Health Program, and Michael Cannon, Cato Institute, Director of Health Policy Studies
I tried to paraphrase this interview, but finally just gave up and transcribed it. The topic was health care. It was an unusually long interview, a full six minutes. For some reason, throughout the whole discussion, I kept thinking about Dickens' "A Christmas Carol" and Serling's "The Twilight Zone".
O'Reilly: "Right now it is estimated 43 million Americans lack health insurance. Is it the government's moral obligation to provide those people with help? Both President Bush and John Kerry say it is." O'Reilly gives two differing costs for the Bush and Kerry plans, based on research done by Kenneth Thorpe of Emory University. According to Mr. Thorpe, the Bush plan would cost $90 billion over 10 years and the Kerry plan would cost $653 billion over the same period without drug benefits. It was unclear from O'Reilly's wording whether it was both plans or just the Kerry plan that did not cover prescriptions.
O'Reilly: "Here's my problem with the government's paying for all of our health. Some people smoke. Some people overeat. Some people take narcotics. Some people don't take care of themselves. Do you think that I, as a taxpayer, have a moral obligation, when their health collapses, to pay for them?"
WOOLHANDLER: "Well, as human beings, we have an obligation to take care of each other when we get sick."
O'Reilly: "Even if you're irresponsible? Even if their illness is (inaudible)?
WOOLHANDLER: All of us eat the occasional cheeseburger. None of us are perfect. But, when we get sick, we take care of each other. Every other developed country has gone with national health insurance, has some form of universal coverage. If you look at Canada and western Europe, those people have complete free choice of doctor or hospital. Those people live 2 to 3 years longer than we do, and they do it through national health insurance. The beauty of national health insurance is, by going with administrative simplification, getting rid of all the insurance company paperwork, we could save about $300 billion just in paperwork costs."
O'Reilly: "But we'd have to set up another huge bureaucracy...The federal government, as you know, is not known for its efficiency."
WOOLHANDLER: "No. Absolutely not. No. You're absolutely wrong. The Medicare program runs at an overhead of less than 3%. The average HMO runs at an overhead of 18 with some of them going at 20 or even 25 percent. You've got those administrative savings. That's the key to making it work."
O'Reilly: "Dollars and cents is one thing. Moral obligation is something else. If somebody is irresponsible, if they smoke crack, if they're an alcoholic, if they take heroin, if they overeat, I don't know why I should be compelled by my government to pay for their destructive behavior and nobody, including you, Doctor, with all due respect, has been able to answer that question."
WOOLHANDLER: "Bill, I'm a doctor and I have to tell you, everyone gets sick, everyone eventually does, and, before they die, they get sick."
O'Reilly: "Oh, but you're dodging my question. I'm a compassionate guy and I give a lot of money to charities who help people who need help. But, there are a lot - we live in a free society, Doctor, where people are free to destroy themselves and you want me to pay for their health benefits, and ya' can't answer that."
WOOLHANDLER: "There's 10 million uninsured children. If an uninsured child gets leukemia, are you gonna let them die? Of course not. We take care of each other because that's what human beings do and it's so affordable. If you get those administrative savings, you can afford it."
O'Reilly: "All right. Let's get Mr. Cannon to reply to the Canadian and western Europe model. You don't, you don't like that, Mr. Cannon. Why?"
CANNON: "Well, if you've been following the news - and, I think,you have - you'll see an example of why. You'll notice that President Clinton in the last couple of days underwent bypass surgery. He had to wait only 4 days from going in to see the doctor until when he received quadruple bypass surgery. Compare that to the people who live under the kind of health care system that President Clinton wanted us to live under or Dr. Woolhandler wants us to live under. If you look at Canadian patients in the President's position, they have to wait up to 6 weeks to get quadruple bypass surgery. If you look at Ontario, 71 patients in just one year a couple of years ago died while waiting for bypass surgery. And another 120 or so had to be taken off the list..
O'Reilly (overtalks): But, we can do better than Canada...
CANNON: "...they got too sick for surgery."
O'Reilly: "We can do better. What would be wrong with having an option that you could have your private coverage- if you wanted it and could pay for it - and the people who were uninsured, who have no safety net, the government would take care of them? President Clinton's rich enough where he can buy any medical procedure he wants. I don't think the United States would ever go the socialized medicine route. They would give you an option - that people who don't have it would be safety-netted by the government, but the people who are affluent would have their own doctor. What's wrong with that?"
CANNON: "Well, that's what's done in a number of industrialized countries that have socialized systems. Canada is the (out lier??) because Canada does not allow them to go out..."
O'Reilly (overtalks): "Well, I don't want to live in the fascist state that Canada's evolving into. But we wouldn't do that."
CANNON: "But even those systems experience the same waiting lines. In New Zealand and Great Britain the waiting lines for bypass surgery are even longer."
O'Reilly: "All right. You didn't answer my question. We could devise a better system here. What would be wrong with giving 43 million Americans a safety net of health insurance?"
CANNON: "Well, the problem is not that we have 43 or 45 million Americans without health [insurance]. The problem is we have 280 million Americans without health savings accounts. And the reason that health insurance is so expensive and the health care is so expensive is everyone treats it as though it were free. If people are spending someone else's money, then you don't get the kind of competition that lowers prices and drives up quality that you see in other markets. Take automobiles. Take cell phones. Take computers. In each one of these markets, you have savvy, choosy consumers, spending their own dollars, and producers have to compete for those dollars. You don't get that in the health care system because we're all spending someone else's money."
O'Reilly: "But, you know....there's a segment of our population who can't or won't compete and they're the segment that are largely uninsured. All right, Doctor, I'm gonna allow you to respond to Mr. Cannon. Go!"
WOOLHANDLER: "Well, it's not true that people who urgently need heart surgery wait in Canada. When people do scientific studies and look at it, the average wait on an urgent patient is one day. It's not the several weeks that Michael was quoting. The reality is Canadians live 3 years longer, and survey after survey has shown that Canadians get as much care and as high quality care as Americans, while they spend half as much."
O'Reilly (overtalks): "You wouldn't support that..."
WOOLHANDLER (continuing): "They spend $3,000 per capita. We spend $6,000."
O'Reilly: "You certainly wouldn't support the Canadian system of denying somebody the right to buy their own medical [insurance], if they wanted to and had the money. You wouldn't do that, would you?"
WOOLHANDLER: "We have the same thing under Medicare. We have exactly the same rule. It's illegal to sell private insurance that competes with Medicare."
O'Reilly: "You're OK with that?"
WOOLHANDLER: "And I'm fine with that. Oh, yes, sure. That's how you get a good public system is mixture, everyone in it, rich people and poor people. Keep them in the same system. You have a much...
O'Reilly (interrupts): "Well, Doctor, you and I have a real strong philosophical difference. I don't want any government telling me I can't go to a doctor, if I have the money to pay for it, and I don't want any government making me...."
WOOLHANDLER: "No. That's not - OK, you can go to any doctor you want in Canada. Your insurance card is good. Any doctor you want.
O'Reilly: "If I want to go to a doctor in Pakistan..."
WOOLHANDLER: "You just can't buy other insurance!."
